week 8

Question 1

potassium

Answer 1

affect muscle contraction and heart functions
hang out in the ICF

Question 1

causes of hyperkalemia (high potassium)

Answer 1

o Renal/kidney failure (cannot excrete potassium)

o Excessive intake of potassium

o Massive cell destruction (burn, shift of potassium between cells)

o Metabolic (kidney) acidosis (high acidity, ph drops below 7.35) (K+ ions move out of the cell and H+moves in)
o Drugs (ie., potassium-sparing
diuretics)

o Hyperglycemia (high blood sugar level), insulin affects the sodium-potassium pump, insulins will make potassium to leave the cells and get into blood stream

Adrenal insufficiency (low Aldosterone ) aldosterone helps the kidneys to hold onto sodium, hold onto water, get rid of potassium

Question 2

sign and symptoms of hyperkalemia

Answer 2

muscle contraction and cardiac function > too much stimulus, muscls and heart are tired

potassium >5 mEq
Symptoms: “Limp is a Fact”
Loss of muscle tone
Irregular pulse, rhythm
Muscle weakness
Paresthesias (tingling sensation)
 reflexes
Fatigue,
irritability
Abdominal cramping (diarrhea)
Confusion
Twitching (muscle cramps)

Respiratory depression (in the late stage)

Question 3

hypotonic

Answer 3

hypotonic solutions have more water than solutes (compared to isotonic)
Fluid will move into cells

Think: HIPPOS!
-Hypotonic solutions have more water than solutes (compared to isotonic solutions)
-Hypotonic solutions cause fluid to move INTO cells
-The cell will expand and burst

Question 4

Hyperkalemia nursing implications

Answer 4

Nursing Implications:
 Mild elevation and renal function: withhold K+ from diet
 Assess medication use
 Assess cardiac function (cardiac monitoring high level to
detect dysrhythmias)
 Assess muscle function and strength
 Assess reflexes
 Assess bowel function and character of stool
 May need diuretics to promote excretion
 Assess glucose and K+ levels with insulin therapy

Question 5

hypertonic

Answer 5

hypertonic solutions have more solutes (particles) than water(compared to isotonic)
Fluid will move out of cells

Think: HYPER cells!
-Hypertonic solutions have more solutes than water (compared to isotonic solutions)
-Hypertonic solutions will cause fluid to move OUT of the cell
-The cell will shrivel

Question 6

high blood sugar lead to increase or decrease potassium ?

Answer 6

high blood sugar will lead to increase in potassium because potassium wants to move outside.

Question 7

how does insulin affect potassium level ?

Answer 7

Insulin affects the sodium-potassium pump, and will make potassium drops.
Potassium moves back to the ICF.

If you give someone insulin, need to monitor potassium and make sure it is not low.

Question 8

Aldosterone

Answer 8

It is released if the blood pressure or fluid volume get too low.

Kidney to Hold on to water
kidney to Hold on to sodium
Get rid of potassium

Question 9

ADH Anti diuretics hormones

Answer 9

Anti diuretics (keep water)

Question 10

Normal pH
acidic
basic

Answer 10

is 7.35-7.45
acidic when it is less than <7.35
basic when it is greater than >7.45

Question 11

Sodium (Na+) normal level

Answer 11

(135-145mEq/L)

Question 12

Chloride/bicarbonate level

Answer 12

chloride and bicarbonate has opposite relationship. When chloride is high, bicarb is low

Question 13

Chloride imbalance needs to check what labs

Answer 13

sodium level
bicarb level
potassium level

Question 14

Chloride (Cl-) normal range

Answer 14

95-105 mEq/L

Question 15

sign and symptom of hyponatremia and hypochloremia

Answer 15

headache, lethargy, confusion,
seizures & coma (severe)
* muscle cramps
* dry mucous membranes
* postural hypotension,
tachycardia

They affect the nerve impulse, and muscle contraction (CNS + muscle contraction)

Monitor for neuro status

Question 16

foods that are rich in chloride

Answer 16

seaweed, rye, tomatoes, lettuce, celery, and olives.

Question 17

foods that are rich in potassium

Answer 17

Potatoes
Oranges
Tomatoes
Avocados
Strawberries
Spinach
raIsins
mUshrooms
Melon, cantaloupeBananas

Question 18

acid ph base

Answer 18

0 1 7 (neutral) 8 9

Question 19

lactated ringer’s and chloride level

Answer 19

Lactated ringers lower the chloride level because it increases bicarb and bicarb has opposite relationship with chloride.

Question 20

BUN
blood urea nitrogen

Answer 20

 Measures amount of urea (less toxic from of ammonia) nitrogen in the blood
+ liver converts ammonia to urea

 Urea from protein breakdown

 Indication of kidney and liver function

Elevated level:

 ↑ protein intake, excess protein breakdown, kidney disease,
fluid volume deficit

Decreased level:
 liver failure, low protein diet, fluid volume excess

Nursing Implications:
 assess protein levels, hydration status, assess other liver and
kidney function tests

Question 21

BUN blood urea nitrogen normal lab value

Answer 21

8-20mg/dL

Question 22

normal sodium level

Answer 22

135-145mEq/L